Individual
MARK C WATTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19 BAKER AVE, SUITE 301, POUGHKEEPSIE, NY 12601-1359
(845) 483-5305
(845) 483-5302
Mailing address
19 BRADHURST AVE, SUITE 3100N, HAWTHORNE, NY 10532-2140
(914) 909-9018
(914) 909-9028
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
286555
NY
207T00000X
Neurological Surgery Physician
Primary
42756
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015560
KAISER-COMMERCIAL NUMBER
—
05
—
08874361
—
CO
01
—
286555
NYS LICENSE
NY
Enumeration date
02/27/2007
Last updated
12/15/2021
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